DE102010041626A1 - Method for predicting aneurysm growth - Google Patents

Abstract

The invention relates to a method for predicting the growth of aneurysms on the basis of CFD simulations derived from at least two angiographic recordings with the following steps: S1) First 3-D record (20) of the aneurysm and determination of a first vessel geometry (21) for a first Time point (T1), S2) First CFD simulation (22) based on this first vessel geometry (21), S3) Second 3-D image (23) of the aneurysm and determination of a second vessel geometry (24) at a second, later point in time (T2), S4) Registration (25) of both 3-D recordings (20, 23), S5) Determination (26) of the local growth rate (Vg) from the two 3-D recordings (20, 23), S6) Correlation (27) of the local growth rate (Vg) between the two vessel geometries (21, 24) with hemodynamically derived parameters (29) from the first CFD simulation (22) and storage of the correlation results, S7) based on the second CFD simulation (28) on the second vessel geometry (24) and / or on the first CFD simulation (22), S8) prediction (30) of the vessel geometry (24) and / or the local growth rate at a future point in time (T3) based on the correlation parameters (29), the hemodynamic parameters from the second CFD Simulation (28) under step S7) and the vessel geometry (24) at the second point in time (T2).

Description

The invention relates to a method for predicting the growth of aneurysms based on at least two angiographic images derived CFD simulations.

The present patent application is concerned with the prediction of further aneurysm growth by the inclusion of hemodynamic parameters, e.g. B. simulated flow in the aneurysm and thereby occurring shear forces. These hemodynamic parameters are considered in the literature as important mediators of growth, as this Barry J. Doyle et al. in "A comparison of modulating techniques for computing wall stress in abdominal aortic aneurysms" it can be seen [1].

A hemodynamic parameter is understood in particular to mean a parameter which relates to hemodynamics, that is to say a fluidic mechanism of the blood. In order to infer such hemodynamic parameters, for example, the blood flow in a vessel section, which comprises, for example, the aneurysm, is simulated.

Abdominal aortic aneurysms (AAA) refer to enlargements of the abdominal aorta below the origin of the renal arteries to more than 3 cm. The number of patients treated for non-ruptured abdominal aortic aneurysm (AAA) in German hospitals was 11,697 in 2002; since then it has risen slightly to 12,531 cases in 2007. The proportion of women is 15%. The number of patients with ruptured AAA also increased from 1,899 in 2000 to 2,350 in 2007. In the case of an arterial aneurysm, the artery has been expanded 1.5-fold. Since the infrarenal aortic diameter is usually about 2 cm, an abdominal aortic aneurysm from a diameter of 3.0 cm has been defined in epidemiological studies. However, one must consider that the aortic diameter increases with age and is slightly larger in men than in women. In clinical practice, with a diameter of 3 to 4 cm, this is often referred to as aneurysmal dilatation of the infrarenal aorta or abdominal aortic ectasia.

The average increase in size of the AAA is 2 to 3 mm / year, it is higher in smokers, but may vary individually but significantly. The risk of rupture of an AAA <4 cm is less than 2% per year, but increases exponentially from a diameter of> 5 cm. Risk factors for impending rupture include, in addition to the maximum diameter, a rapid increase in diameter (> 0.5-1 cm / year), familial stress, eccentric morphology, and continued nicotine abuse, such as Hans-Henning Eckstein et al. in "Ultrasound Screening of Abdominal Aortic Aneurysms" is described [2].

The problem after a diagnosis of AAA is the decision to make, whether the aneurysm should be treated, the patient must undergo open surgery or endovascular therapy, or the aneurysm is merely observed, generally by a regular CT scan. The essential parameter for this decision is the question of how fast the AAA is likely to develop, that is, what growth rate is predicted for the AAA.

The problem lies in the fact that in addition to the growth-induced effect of hemodynamic parameters and patient-specific parameters such as genetics, pre-existing diseases or behavior play an important role.

Numerous studies are now using a CFD simulation to calculate hemodynamic parameters, such as wall shear stress (WSS) or pressure in an AAA, to further predict the future growth of an AAA. This is for example Barry J. Doyle et al., "A Comparison of Modulation Techniques for Computing Wall Stress in Abdominal Aortic Aneurysms" . David S. Molony et al., "Fluid-structure interaction of a patient-specific abdominal aortic aneurysm treated with endovascular stent graft" , or James H Leung et al., "Fluid structure interaction of patient specific abdominal aortic aneurysms: a comparison with solid stress models" to be taken [1, 3, 4].

"Computational Fluid Dynamics", also referred to as CFD for short, is a method to simulate the blood flow in a vessel section or vessel segment of a blood vessel, which includes a pathological, ie a pathological change. Such a pathological change of the vascular segment is, for example, in the form of an aneurysm, that is to say a pathological, localized, often bag-like enlargement. In particular, an aneurysm can occur in a blood vessel in the region of the brain or the heart; however, the appearance of an aneurysm is generally not limited to a particular body region. The clinical significance of an aneurysm, which is localized for example in the brain, is in particular due to the risk of rupture, so a crack or fracture, which may, for example, lead to bleeding and thrombosis. The dynamics of blood flow in an aneurysm is often considered in today's medicine as an important factor for the pathogenesis of the aneurysm, ie for its formation and development.

It is also known to determine the growth by comparing several successive examinations of the AAA, for example by means of computed tomography.

The invention is based on the task of predicting the growth of AAAs as the aneurysm evolves, eliminating or at least reducing patient-specific predictors or suboptimal choice of constraints for CFD simulation.

The object is achieved by the features specified in claim 1. Advantageous embodiments are specified in the dependent claims.

The object is achieved according to the invention by the following steps:
S1) First 3-D image of the aneurysm and determination of a first vessel geometry at a first time,
S2) First CFD simulation based on this first vessel geometry,
S3) Second 3-D image of the aneurysm and determination of a second vessel geometry at a second, later time,
S4) registration of both 3-D recordings,
S5) determination of the local growth rate from the two 3-D images,
S6) Correlation of the local growth rate between the two vessel geometries with haemodynamically derived parameters from the first CFD simulation and storage of the correlation results,
S7) Second CFD simulation based on the second vessel geometry and / or on the first CFD simulation,
S8) prediction of vessel geometry and / or local growth rate at a future time based on the correlation parameters, the hemodynamic parameters from the second CFD simulation under step
S7) and the vessel geometry at the second time.

By correlating CFD simulations and vascular measurements, one can better predict aneurysm growth without affecting patient-specific predictors or boundary conditions for CFD simulation.

• • Computertomographie (CT),
• • Magnetresonanztomographie (MRI),
• • Ultraschall (US) und/oder
• • Angiographie (DynaCT)

erstellt werden.Advantageously, the 3-D images according to step S1) and step S3) by means of at least one imaging method from the group

• Computed tomography (CT),
• • magnetic resonance imaging (MRI),
• • Ultrasound (US) and / or
• • Angiography (DynaCT)

to be created.

According to the invention, the correlation results according to step S6) can indicate which of the simulated hemodynamic parameters actually contributed to the growth (between T1 and T2) or which of the simulated hemodynamic parameters contributed significantly to the growth of the aneurysm, such as the individual parameters for the growth of the aneurysm contributed and / or the correlation coefficient.

The registration of both 3-D images according to step S4) can be carried out according to the invention rigid or flexible.

It has proved to be advantageous if the lumen and / or the thrombus are used to determine the vessel geometry according to step S1) and step S3).

According to the invention, the determination of the local growth rate is calculated from the increase of the local radius divided by the time between both 3-D images.

Advantageously, the second 3-D recording at the second time (T2) according to step S3) takes place about three months after the first 3-D recording at the first time (T1) according to step S1).

• • ein simulierter Fluss in einem Aneurysma,
• • durch den Blutfluss auftretende Scherkräfte,
• • ein Druck in einem Aneurysma,
• • eine die Gefäßwand betreffende Spannung,
• • eine die Gefäßwand betreffende Scherspannung sowie
• • eine Flussrate

It has proved to be advantageous if the hemodynamically derived parameters according to step S6) and / or step S8) is at least one parameter from the group:

• A simulated flow in an aneurysm,
• Shear forces due to blood flow,
• • pressure in an aneurysm,
• A tension affecting the vessel wall,
• • a shear stress affecting the vessel wall as well
• • a flow rate

The invention is explained in more detail with reference to embodiments shown in the drawing. Show it:

1 a known X-ray system with an industrial robot as a support device for a C-arm,

2 a vessel section based on an angiography recording

3 the inventive method and

4 the inventive steps of the procedure.

To create 3-D images of an aneurysm, for example, various imaging systems such as computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US) and / or rotational angiography (DynaCT) systems can be used.

To perform such Rotationsangiographie for the generation of 3-D image recordings to obtain a 3-D vessel section model, for example, an AAA, X-ray systems are used, whose typical essential features, for example, at least one C-arm, which may be robotically controlled and on the one X-ray tube and an X-ray image detector are mounted, a patient table, a high voltage generator for generating the tube voltage, a system control unit and an imaging system including at least one monitor can be.

Such in the 1 For example, a typical X-ray system with robot-mounted C-arm, shown as an example, has one on a stand in the form of a six-axis industrial or articulated robot 1 rotatably mounted C-arm 2 on, at the ends of an X-ray source, such as an X-ray source 3 with X-ray tube and collimator, and an X-ray image detector 4 are mounted as an image recording unit.

In general, CTA and MRA are also suitable for generating the 3-D models. The advantage of C-arm systems is that, if necessary, the 2-D images are intrinsically registered. Otherwise this is to be done in all modalities.

By means of the example of the US 7,500,784 B2 known articulated robot 1 , which preferably has six axes of rotation and thus six degrees of freedom, the C-arm 2 be spatially adjusted, for example, by turning around a center of rotation between the X-ray source 3 and the X-ray image detector 4 is turned. The X-ray system according to the invention 1 to 4 is in particular about centers of rotation and axes of rotation in the C-arm plane of the X-ray image detector 4 rotatable, preferably around the center of the X-ray image detector 4 and around the center of the X-ray image detector 4 cutting axes of rotation.

The well-known articulated robot 1 has a base frame, which is for example fixedly mounted on a floor. It is rotatably mounted about a first axis of rotation a carousel. On the carousel is pivotally mounted about a second axis of rotation a rocker arm, on which is rotatably mounted about a third axis of rotation, a robot arm. At the end of the robot arm, a robot hand is rotatably mounted about a fourth axis of rotation. The robot hand has a fastener for the C-arm 2 which is pivotable about a fifth axis of rotation and about a perpendicular thereto extending sixth axis of rotation rotatable.

The realization of the X-ray diagnostic device is not dependent on the industrial robot. It can also find common C-arm devices use.

The X-ray image detector 4 may be a rectangular or square semiconductor flat detector, preferably made of amorphous silicon (a-Si). However, integrating and possibly counting CMOS detectors may also be used.

In the beam path of the X-ray source 3 is located on a patient table 5 for receiving, for example, a heart, a patient to be examined 6 as a research object. At the X-ray diagnostic facility is a system control unit 7 with an image system 8th connected to the image signals of the X-ray image detector 4 receives and processes (controls are not shown, for example). The X-ray images can then be displayed on a monitor 9 to be viewed as.

In the 2 is a vessel section 10 as shown in a 3-D image of a baseline at time T1. In a test carried out at a time T2 later than the time T1, for example at the present time, the vessel wall is pointed 11 in an actual 3-D recording an AAA on.

The main problem of predicting the growth of AAAs is the question of how the aneurysm will evolve until a future time T3, when the geometries of the aorta at times T1 and T2 are known.

The goal is now, based on a patient-specific prediction, the course of the future vessel wall 12 to reproduce as accurately as possible with an AAA.

This is through the in 3 symbolically represented method achieved. First, for example, has a DynaCT recording or CT scan as the first 3-D recording 20 or so-called baseline 3-D recording at a first examination time T1, on the basis of which a first vessel measurement 21 can be carried out. By means of this from the first vessel measurement 21 obtained vessel geometry of the vessel section 10 can be a first CFD simulation 22 carry out.

At a second examination time T2, for example today, a current second 3-D image is taken 23 in turn, for example, by means of a DynaCT system or a CT system created, the second vessel measurement 24 for determining a second vessel geometry. Subsequently, a registration takes place 25 both 3-D recordings 20 and 23 and thus also in the vessel geometry of the vessel measurements 21 and 24 ,

From this data 20 . 21 . 23 and 24 become the local growth rates 26 (Vg) determined for each vessel section of the vessel geometry between the first examination time T1 and the second examination time T2.

Between the two vessel geometries 21 and 24 with hemodynamically derived parameters from the first CFD simulation 22 there is a correlation 27 the local growth rate Vg and storage of the correlation results.

Building on the current 3-D recording 23 at the second examination time T2 with the second vessel measurement 24 becomes a second CFD simulation 28 carried out.

From the correlation 27 as well as the second CFD simulation 28 can be calculated which of the simulated hemodynamic parameters 29 actually contributed to the growth of the AAA between T1 and T2. With this information, growth can be better predictive 30 for a future growth of the AAA at a future time of investigation T3 be used, so that one to a prognosis 31 for a third vessel geometry. Because of this forecast 31 It is now possible to assess further measures, whether the aneurysm should be treated, the patient must undergo open surgery or endovascular therapy, or whether the aneurysm must be observed.

In this case, at a third examination time, for example in three months, a 3-D image can be taken again with another vessel measurement. After registration of the 3-D images, the local growth rates Vg for each vascular segment of the vascular geometries are determined between assay times and 1 correlated with hemodynamically-derived parameters from CFD simulations to re-predict future growth of the AAA.

• • ein simulierter Blutfluss in einem Aneurysma,
• • durch den Blutfluss auftretende Scherkräfte,
• • ein Druck in einem Aneurysma,
• • eine die Gefäßwand betreffende Spannung,
• • eine die Gefäßwand betreffende Scherspannung sowie
• • eine Flussrate

The simulated hemodynamic parameters 29 can be for example:

• A simulated blood flow in an aneurysm,
• Shear forces due to blood flow,
• • pressure in an aneurysm,
• A tension affecting the vessel wall,
• • a shear stress affecting the vessel wall as well
• • a flow rate

The intermediate steps of the growth rates Vg for each vessel section of the vessel geometries between the examination times can be interpolated in order to be able to create a continuous growth profile later, if necessary. This can be used to create virtual intermediate models and use them for CFD simulations, so that an iterative control or adaptation is possible.

The method according to the invention for predicting aneurysm growth is therefore based on the idea of calculating from the known measurements and simulations at time T1 and T2 (today) by correlation which of the simulated parameters actually contributed to the growth (between T1 and T2). With this information, the growth at time T3 can then be better predicted.

The process according to the invention in brief is:
In a first step S1), a first 3-D image is taken 20 of the aneurysm and determination of a first vessel geometry at a first time T1.

Subsequently, according to a second step S2), a first CFD simulation is performed 22 based on this first vessel geometry.

In a third step S3), a second 3-D recording 23 of the aneurysm and a provision 24 a second vessel geometry at a second, later time T2 performed.

According to a fourth step S4), both 3-D shots 20 and 23 registered with each other ( 25 ).

In a fifth step S5), a determination is made 26 the local growth speed from the two 3-D shots 20 and 23 ,

Subsequently, according to a sixth step S6), a correlation 27 the local growth rate between the two vessel geometries with hemodynamically derived parameters from the first CFD simulation 22 and storing the correlation results.

In a seventh step S7), a second CFD simulation is performed 28 based on the second vessel geometry and / or on the first CFD simulation 22 ,

Finally, a prediction takes place in an eighth step S8) 30 the vessel geometry and / or the local growth rate at a future time (T3) due to the correlation parameters 29 , the hemodynamic parameters from the second CFD simulation 28 under step S7) and the vessel geometry 24 at the second time (T2).

The method of the invention provides a simple way to combine personal factors with the results of hemodynamic simulations and to provide an improved basis for predicting the further growth of an aneurysm.

For this purpose, it is proposed according to the invention to record the growth of an AAA by means of at least two consecutive 3-D imaging methods and to correlate the derived growth rate with hemodynamically derived variables (eg WSS) from a CFD simulation and transfer the result to a second CFD simulation. Apply simulation.

• – Mindestens zwei Aufnahmen der Aorta zu zwei verschiedenen Zeitpunkten T1 und T2 sind erstellt worden, aus denen man das lokale AAA Wachstum bestimmen bzw. messen kann.
• – Diese zwei Aufnahmen sind zueinander registriert, wobei die Registrierung rigide oder flexibel sein kann.
• – Für die Aufnahme zum Zeitpunkt T1 liegt eine CFD-Simulation der Aorta vor.

Prerequisite for the proposed method are:

• - At least two recordings of the aorta at two different times T1 and T2 have been created, from which one can determine or measure the local AAA growth.
• - These two images are registered with each other, whereby the registration can be rigid or flexible.
• - For admission at time T1, a CFD simulation of the aorta is available.

• – Die Zwischenschritte im Wachstum können interpoliert werden, um ggf. später ein kontinuierliches Wachstumsprofil erstellen zu können. Damit können virtuelle Zwischenmodelle erzeugt werden und diese für CFD-Simulationen verwendet werden. Damit ist eine iterative Kontrolle, bzw. Anpassung möglich.

optional:

• - The intermediate steps in the growth can be interpolated, in order to be able to create a continuous growth profile later. With this, virtual intermediate models can be created and used for CFD simulations. For an iterative control, or adaptation is possible.

• – Nun wird die CFD-Simulation zum Zeitpunkt T1 korreliert mit dem (tatsächlich gemessenen) AAA Wachstum zwischen Zeitpunkt T1 und T2. Dadurch kann bestimmt werden:
• – Welcher der simulierten hämodynamischen Parameter maßgeblich zum Wachstum des Aneurysmas beigetragen hat.
• – Wie die einzelnen Parameter zum Wachstum des Aneurysmas beigetragen haben.
• – Der Korrelationskoeffizient.

Correlation of measurements and simulations:

• Now the CFD simulation at time T1 is correlated with the (actually measured) AAA growth between time T1 and T2. This can determine:
• - Which of the simulated hemodynamic parameters contributed significantly to the growth of the aneurysm?
• - How the individual parameters contributed to the growth of the aneurysm.
• - The correlation coefficient.

• – Wird nun eine CFD-Simulation der Aortenaufnahme zum Zeitpunkt T2 erstellt, kann mit dieser, den vorher bestimmten Korrelationsparametern und der Gefäßgeometrie zum Zeitpunkt T2 eine bessere Vorhersage des Wachstums gemacht werden.

Prediction of aneurysm growth:

• - If a CFD simulation of the aortic uptake is made at time T2, this, the previously determined correlation parameters and the vessel geometry at time T2 can be used to better predict the growth.

• 1. Erste 3-D-Aufnahme (CT, MRI, US, DynaCT) des AAA und Bestimmung der Gefäßgeometrie (Lumen, Thrombus),
• 2. CFD-Simulation basierend auf dieser Geometrie,
• 3. Zweite 3-D-Aufnahme des AAA und Bestimmung der Gefäßgeometrie (Lumen, Thrombus) z. B. nach 3 Monaten,
• 4. Registrierung (rigide oder flexibel) beider 3-D-Aufnahmen,
• 5. Bestimmung der lokalen Wachstumsgeschwindigkeit (z. B. Zunahme des lokalen Radius geteilt durch die Zeit zwischen beiden 3-D-Aufnahmen),
• 6. Korrelation der lokalen Wachstumsgeschwindigkeit mit den Ergebnissen aus der CFD-Simulation der ersten Geometrie. Diese werden gespeichert,
• 7. CFD-Simulation basierend auf der zweiten Geometrie,
• 8. Vorhersage der zukünftigen Gefäßgeometrie und/oder der zukünftigen lokalen Wachstumsgeschwindigkeit aufgrund der Korrelationsparameter, den hämodynamischen Parametern aus der zweiten CFD-Simulation unter Punkt S7 und der Gefäßgeometrie zum zweiten Zeitpunkt.

Example of a workflow:

• 1. First 3-D image (CT, MRI, US, DynaCT) of the AAA and determination of the vessel geometry (lumen, thrombus),
• 2. CFD simulation based on this geometry,
• 3. Second 3-D image of the AAA and determination of the vessel geometry (lumen, thrombus) z. After 3 months,
• 4. Registration (rigid or flexible) of both 3-D recordings,
• 5. determination of local growth rate (eg increase in local radius divided by the time between both 3-D acquisitions),
• 6. Correlation of the local growth rate with the results from the CFD simulation of the first geometry. These are saved
• 7. CFD simulation based on the second geometry,
• 8. Prediction of future vascular geometry and / or future local growth rate based on the correlation parameters, hemodynamic parameters from the second CFD simulation under point S7, and vessel geometry at the second time point.

• a) einem (oder mehreren) simulierten hämodynamischen Parametern in einem definierten Simulationssetting mit
• b) dem individuellen (tatsächlich zwischen zwei oder mehreren Scans gemessen) Aneurysmen-Wachstum, um zu sehen, wie sich diese Parameter auf das weitere Wachstum auswirken.

Specifically, a correlation is proposed between

• a) one (or more) simulated hemodynamic parameters in a defined simulation setting
• b) the individual aneurysm growth (actually measured between two or more scans) to see how these parameters affect further growth.

The proposed solution can be used in principle for all types of aneurysms, including, for example, for thoracic aortic aneurysms or intracranial aneurysms. However, the description refers to AAAs for convenience only.

Patient-specific factors such as genetics or suboptimal choice of boundary conditions for the CFD simulation are eliminated by the method according to the invention. The prediction can be verified in aneurysms under observation with new 3-D imaging.

references

• [1] Barry J. Doyle, Anthony Callanan and Timothy M. McGloughlin; A comparison of modulating techniques for computing wall stress in abdominal aortic aneurysms; BioMedical Engineering OnLine 2007, 6:38; Pages 1 to 12
• [2] Hans-Henning Eckstein, Dittmar Böckler, Ingo Flessenkämper, Thomas Schmitz-Rixen, Sebastian Debus, Werner Lang; Ultrasound screening of abdominal aortic aneurysms; Deutsches Ärzteblatt, Jg. 106, No. 41, 9 October 2009, pages 657 to 663
• [3] David S. Molony, Anthony Callanan, Eamon G. Kavanagh, Michael T. Walsh, and Tim M. McGloughlin; Fluid-structure interaction of a patient-specific abdominal aortic aneurysm treated with an endovascular stent-graft; BioMedical Engineering OnLine 2009, 8: 24; Pages 1 to 12
• [4] James H Leung, Andrew R Wright, Nick Cheshire, Jeremy Crane, Simon A Thom, Alun D Hughes and Yun Xu; Abdominal aortic aneurysm: a comparison with solid stress models; BioMedical Engineering OnLine 2006, 5: 33, pages 1 to 15

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• US 7500784 B2 [0031]

Cited non-patent literature

• Barry J. Doyle et al. in "A Comparison of Modulation Techniques for Computing Wall Stress in Abdominal Aortic Aneurysms" [0002]
• Hans-Henning Eckstein et al. in "Ultrasound Screening of Abdominal Aortic Aneurysms" [0005]
• Barry J. Doyle et al., "A Comparison of Modulation Techniques for Computing Wall Stress in Abdominal Aortic Aneurysms" [0008]
• David S. Molony et al., "Fluid-structure interaction of a patient-specific abdominal aortic aneurysm treated with an endovascular stentgraft" [0008]
• James H Leung et al., "Fluid structure interaction of patient specific abdominal aortic aneurysms: a comparison with solid stress models" [0008]

Claims (9)

A method for predicting the growth of aneurysms based on at least two angiographic images derived CFD simulations comprising the steps of: S1) first 3-D image ( 20 ) of the aneurysm and determination of a first vessel geometry ( 21 ) at a first time (T1), S2) First CFD simulation ( 22 ) based on this first vessel geometry ( 21 ), S3) Second 3-D image ( 23 ) of the aneurysm and determination of a second vessel geometry ( 24 ) at a second, later time (T2), S4) registration ( 25 ) of both 3-D images ( 20 . 23 ), S5) Determination ( 26 ) of the local growth rate (Vg) from the two 3-D images ( 20 . 23 ), S6) Correlation ( 27 ) of the local growth rate (Vg) between the two vessel geometries ( 21 . 24 ) with hemodynamically derived parameters ( 29 ) from the first CFD simulation ( 22 ) and storage of the correlation results, S7) Second CFD simulation ( 28 ) based on the second vessel geometry ( 24 ) and / or on the first CFD simulation ( 22 ), S8) prediction ( 30 ) of the vessel geometry and / or the local growth rate at a future point in time (T3) on the basis of the correlation parameters ( 29 ), the hemodynamic parameters from the second CFD simulation ( 28 ) under step S7) and the vessel geometry ( 24 ) at the second time (T2). Method according to claim 1, characterized in that the 3-D recordings ( 20 . 23 ) according to step S1) and step S3) by means of at least one imaging method from the group • computed tomography (CT), • magnetic resonance imaging (MRI), • ultrasound (US) and / or • angiography (DynaCT). A method according to claim 1 or 2, characterized in that the correlation results according to step S6) indicate which of the simulated hemodynamic parameters actually contributed to the growth (between T1 and T2). Method according to one of claims 1 to 3, characterized in that the correlation results according to step S6) indicate which of the simulated hemodynamic parameters contributed significantly to the growth of the aneurysm, how the individual parameters contributed to the growth of the aneurysm and / or the correlation coefficient. Method according to one of claims 1 to 4, characterized in that the registration ( 25 ) of both 3-D images ( 20 . 23 ) in step S4) takes place rigidly or flexibly. Method according to one of claims 1 to 5, characterized in that for the determination ( 21 . 24 ) of the vessel geometry according to step S1) and step S3) the lumen and / or the thrombus are used. Method according to one of claims 1 to 6, characterized in that the determination of the local growth rate (Vg) from the increase of the local radius divided by the time between both 3-D images ( 20 . 23 ). Method according to one of claims 1 to 7, characterized in that the second 3-D recording ( 23 ) at the second time (T2) according to step S3) about three months after the first 3-D recording ( 20 ) at the first time (T1) in step S1). Method according to one of claims 1 to 8, characterized in that the hemodynamically derived parameters according to step S6) and / or step S8) at least one parameter is selected from the group: A simulated blood flow in an aneurysm, Shear forces due to blood flow, The blood flow velocity, • pressure in an aneurysm, A tension affecting the vessel wall, • a shear stress affecting the vessel wall as well • a flow rate.

Images